Persons with schizophrenia spectrum disorder (SSD) have a shorter life expectancy than the general population, mainly due to physical comorbidities. However, current health screening practices are inadequate for the needs of this patient group. The aim of this mixed methods study was to examine the implementation of physical health screening in persons with schizophrenia spectrum disorder using the Finnish Health Improvement Profile (HIP-F). The face and content validity, clinical utility, perceptions of nurses and patients, and implementation fidelity and related factors of the HIP-F were described. The study applied a socio-ecological model, which enabled the examination of factors related to the implementation of health screening at several levels.

The study was conducted in three phases. First, the face and content validity of the HIP-F tool and its potential clinical utility, was evaluated using questionnaires. Second, nurses’ and patients' perceptions of HIP-F screening and suggestions for improvement were assessed. Perceptions were collected from nurses through group interviews, and from patients through individual interviews, in a semi-structured manner. Third, nurses' implementation fidelity was assessed using a survey and related factors were assessed using interviews. The survey data were analyzed using statistical methods and the interview data using content analysis. The findings from all phases were combined and presented as a single, cohesive report in the discussion section of this study.

The HIP-F demonstrated acceptable face validity, moderate content validity and potential clinical utility to detect health risks in patients with SSD. It was found to be comprehensive, and it contributed to patients’ engagement and knowledge related to physical health. While patients found HIP-F easy to use, the majority of nurses perceived it as time-consuming and difficult to use. Nurses’ implementation fidelity was low, influenced by their work tasks, the lack of resources and patient-related factors. This dissertation provides knowledge that can be utilized in clinical practice, in healthcare administration, in research on nursing science, and in nursing education with the purpose of improving screening practices. Further research is needed to examine the effectiveness of physical health screening, nurse-patient interaction, organizational readiness, and the gap between clinical guidelines and practice.